Individual
AMY WIEBOLDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1579 NE RICE RD, LEES SUMMIT, MO 64086-5849
(816) 966-0900
(816) 347-3200
Mailing address
1555 NE RICE RD, LEES SUMMIT, MO 64086-5849
(816) 966-0900
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2023042126
MO
1041C0700X
Clinical Social Worker
2023042126
MO
1041C0700X
Clinical Social Worker
Primary
2025050005
MO
Other
Enumeration date
05/06/2024
Last updated
11/21/2025
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